Early detection of psychosis - establishing a service for persons at risk.
OBJECTIVE
The establishment phase of an early detection centre for prodromal psychosis is introduced and characterised, along with its detaining and promoting factors within a universal multi-payer health care system.


METHODS
Across the first six years (1998-2003), users' characteristics are compared between different diagnostic groups and to the local population statistics; and, for an exemplary 12-months period (3-1-2002 to 2-28-2003), the characteristics of telephone contacts with the service are studied.


RESULTS
Rising steadily in number across the first three years, 872 persons, predominantly of German citizenship and higher education, consulted the service until 2003, 326 with first-episode psychosis and 144 not fulfilling criteria for a current or beginning psychosis. Of the 402 putatively prodromal patients, 94% reported predictive basic symptoms, 68.9% attenuated and 20.6% transient psychotic symptoms. Most contacts by persons meeting any prodromal criterion were initiated by mental health professionals (psychiatrists or psychologists) and counselling services.


CONCLUSIONS
Supported by public awareness campaigns, an early detection service is well received by its users and private practitioners as reflected by the large proportion of referrals from the latter. However, persons of non-German background as well as of lower education were underrepresented indicating that these sub-groups should be approached by tailored programmes.
Schultze-Lutter
Frauke
F
University of Cologne, Department of Psychiatry and Psychotherapy, 50924 Cologne, Germany. frauke.schultze-lutter@uk-koeln.de
Ruhrmann
Stephan
S
Klosterkötter
Joachim
J
D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005858:Germany; D006293:Health Promotion / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D012959:Socioeconomic Factors; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult